@article{22082, author = {O'Connor S. and Weatherall M. and Rodgers H. and Delaney A. and Gantner D. and Wong K. and Richards B. and Bell S. and Bellomo R. and Robertson M. and Cohen J. and Young P. and Eastwood G. and Newby L. and Smith J. and Saxena M. and Myburgh J and Litton E. and Cheng A. and Ridgeon E. and Jahan R. and Arawwawala D. and Butt W. and Camsooksai J. and Carle C. and Cirstea E. and Cranshaw J. and Eliott S. and Franke U. and Green C. and Howard-Griffin R. and Inskip D. and MacIsaac C. and McCairn A. and Mahambrey T. and Moondi P. and Pegg C. and Pope A. and Reschreiter H. and Shehabi Y. and Smith I. and Smith N. and Tilsley A. and Whitehead C. and Willett E. and Woodford C. and Wright S.}, title = {Validation of a classification system for causes of death in critical care: an assessment of inter-rater reliability}, abstract = {

OBJECTIVE: Trials in critical care have previously used unvalidated systems to classify cause of death. We aimed to provide initial validation of a method to classify cause of death in intensive care unit patients. DESIGN, SETTING AND PARTICIPANTS: One hundred case scenarios of patients who died in an ICU were presented online to raters, who were asked to select a proximate and an underlying cause of death for each, using the ICU Deaths Classification and Reason (ICU-DECLARE) system. We evaluated two methods of categorising proximate cause of death (designated Lists A and B) and one method of categorising underlying cause of death. Raters were ICU specialists and research coordinators from Australia, New Zealand and the United Kingdom. MAIN OUTCOME MEASURES: Inter-rater reliability, as measured by the Fleiss multirater kappa, and the median proportion of raters choosing the most likely diagnosis (defined as the most popular classification choice in each case). RESULTS: Across all raters and cases, for proximate cause of death List A, kappa was 0.54 (95% CI, 0.49-0.60), and for proximate cause of death List B, kappa was 0.58 (95% CI, 0.53-0.63). For the underlying cause of death, kappa was 0.48 (95% CI, 0.44-0.53). The median proportion of raters choosing the most likely diagnosis for proximate cause of death, List A, was 77.5% (interquartile range [IQR], 60.0%-93.8%), and the median proportion choosing the most likely diagnosis for proximate cause of death, List B, was 82.5% (IQR, 60.0%-92.5%). The median proportion choosing the most likely diagnosis for underlying cause was 65.0% (IQR, 50.0%-81.3%). Kappa and median agreement were similar between countries. ICU specialists showed higher kappa and median agreement than research coordinators. CONCLUSIONS: The ICU-DECLARE system allowed ICU doctors to classify the proximate cause of death of patients who died in the ICU with substantial reliability.

}, year = {2016}, journal = {Critical Care and Resuscitation}, volume = {18}, edition = {2016/03/08}, number = {1}, pages = {50-4}, isbn = {1441-2772 (Print)
1441-2772 (Linking)}, note = {Ridgeon, Elliott
Bellomo, Rinaldo
Myburgh, John
Saxena, Manoj
Weatherall, Mark
Jahan, Rahi
Arawwawala, Dilshan
Bell, Stephanie
Butt, Warwick
Camsooksai, Julie
Carle, Coralie
Cheng, Andrew
Cirstea, Emanuel
Cohen, Jeremy
Cranshaw, Julius
Delaney, Anthony
Eastwood, Glenn
Eliott, Suzanne
Franke, Uwe
Gantner, Dashiell
Green, Cameron
Howard-Griffin, Richard
Inskip, Deborah
Litton, Edward
MacIsaac, Christopher
McCairn, Amanda
Mahambrey, Tushar
Moondi, Parvez
Newby, Lynette
O'Connor, Stephanie
Pegg, Claire
Pope, Alan
Reschreiter, Henrik
Richards, Brent
Robertson, Megan
Rodgers, Helen
Shehabi, Yahya
Smith, Ian
Smith, Julie
Smith, Neil
Tilsley, Anna
Whitehead, Christina
Willett, Emma
Wong, Katherine
Woodford, Claudia
Wright, Stephen
Young, Paul
Australia
Crit Care Resusc. 2016 Mar;18(1):50-4.}, language = {eng}, }